-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, VqF4USFghtj/kWyhmrZhCozLplAd36sHYrpAQ5PnCS7VCkZriXZtTfJQgtnetUyz MgcotHZGvKL8wJOeH4DJLg== 0000931731-04-000023.txt : 20040205 0000931731-04-000023.hdr.sgml : 20040205 20040205122414 ACCESSION NUMBER: 0000931731-04-000023 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040204 FILED AS OF DATE: 20040205 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LAMPROPOULOS FRED P CENTRAL INDEX KEY: 0000901534 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-18592 FILM NUMBER: 04569209 BUSINESS ADDRESS: STREET 1: 1600 W MARIT PARKWAY CITY: SO JORDAN STATE: UT ZIP: 84095 BUSINESS PHONE: 84095-1688 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MERIT MEDICAL SYSTEMS INC CENTRAL INDEX KEY: 0000856982 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 870447695 STATE OF INCORPORATION: UT FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1600 WEST MERIT PARK WAY CITY: SOUTH JORDAN STATE: UT ZIP: 84095 BUSINESS PHONE: 8012531600 MAIL ADDRESS: STREET 1: 1600 WEST MERIT PARKWAY CITY: SOUTH JORDAN STATE: UT ZIP: 84095 4 1 form4-fpl020404_ex.xml X0201 4 2004-02-04 0 0000856982 MERIT MEDICAL SYSTEMS INC MMSI 0000901534 LAMPROPOULOS FRED P 1600 W MARIT PARKWAY SO JORDAN UT 84095 1 1 1 0 President, CEO Common Stock, no par value 1988-08-08 1988-08-08 4 M 0 843064 A 843064 D Common Stock, no par value 1988-08-08 1988-08-08 4 M 0 54873 A 54873 I by 401(k) Plan Non-qualified Stock Option (right to buy) 2.07 1988-08-08 1988-08-08 4 M 0 55556 2.07 A 1999-09-30 2004-03-31 Common Stock 55556 55556 D Non-qualified Stock Option (right to buy) 2.12 1988-08-08 1988-08-08 4 M 0 20833 2.12 A 1999-05-26 2004-05-26 Common Stock 20833 20833 D Non-qualified Stock Option (right to buy) 1.62 1988-08-08 1988-08-08 4 M 0 20833 1.62 A 2000-05-24 2005-05-24 Common Stock 20833 20833 D Non-qualified Stock Option (right to buy) 1.62 1988-08-08 1988-08-08 4 M 0 11111 1.62 A 2001-01-24 2005-05-24 Common Stock 11111 11111 D Non-qualified Stock Option (right to buy) 2.07 1988-08-08 1988-08-08 4 M 0 11111 2.07 A 2002-02-12 2011-02-12 Common Stock 11111 11111 D Non-qualified Stock Option (right to buy) 2.85 1988-08-08 1988-08-08 4 M 0 27777 2.85 A 2001-05-23 2011-05-23 Common Stock 27777 27777 D Non-qualified Stock Option (right to buy) 7.61 1988-08-08 1988-08-08 4 M 0 88889 7.61 A 2002-12-08 2011-12-08 Common Stock 88889 88889 D Non-qualified Stock Option (right to buy) 9.56 1988-08-08 1988-08-08 4 M 0 17777 9.56 A 2002-05-23 2012-05-23 Common Stock 17777 17777 D Non-qualified Stock Option (right to buy) 9.74 1988-08-08 1988-08-08 4 M 0 71111 9.74 A 2002-06-04 2012-06-13 Common Stock 71111 71111 D Non-qualified Stock Option (right to buy) 10.47 1988-08-08 1988-08-08 4 M 0 26667 10.47 A 2003-05-22 2013-05-22 Common Stock 26667 26667 D Non-qualified Stock Option (right to buy) 21.67 2003-12-13 2003-12-13 4 A 0 28000 21.67 A 2004-12-13 2013-12-13 Common Stock 28000 28000 D Non-qualified Stock Option (right to buy) 21.67 2003-12-13 2003-12-13 4 A 0 15000 21.67 A 2003-12-13 2013-12-13 Common Stock 15000 15000 D Represent plan holdings as of 02/03/04 based upon most recent plan statement timely distributed Become exercisable in equal annual installments of 20% commencing 02/12/02 Become exercisable in equal annual installments of 20% commencing 12/08/02 Become exercisable in equal annual installments of 20% commencing 12/13/04 Become exercisable in equal annual installments of 20% commencing 09/30/99 Become exercisable in equal annual installments of 20% commencing 02/06/04 Employee stock purchase Fred P. Lampropoulos 2004-02-04 -----END PRIVACY-ENHANCED MESSAGE-----